Judy Capko

Employees want and need to hear messages that assure them the practice is on a solid, economically sound foundation. It is too easy in difficult times for practice leaders to fall into a sort of business paralysis where they don't want to talk about the negative impact of the economy. Sometimes the manager and physician(s) become less visible to staff when they are concerned about the future. This will not go unnoticed by staff members, who are seeking reassurance and watching to see whether the boss is calm and confident about the practice's position. Employees may be worried about their jobs, and your silence will cause anxiety.

It's important to keep employees in the know. If there are changes in practice finances that may result in broken promises, such as buying equipment that employees are awaiting, let them know there will be a delay in those purchases due to the economy. You also may need to address issues that are personal to them, such as reduced hours, terminations, or not replacing an employee who leaves. It is important to communicate with staff in an honest way.

Monitor changing attitudes

Stay in tune with staff behavior and overall morale. Recognize that you could be sending messages that the practice is not on stable ground. If employees begin bickering and their enthusiasm, customer service, production, and dependability wane, you need to get to the bottom of it.

Employee attitudes are certainly affected by circumstances at work, but there could be external factors as well, such as a spouse losing his job. This makes your employee the breadwinner and possibly not feeling terribly secure. By failing to communicate, you may be inadvertently contributing to these concerns, resulting in staff imagining that things are far worse than they really are.

Address performance issues

Regardless of the source, a change in attitude and job performance cannot be ignored. It simply will not go away until you address it.

If the performance factors are more isolated to different staff members or a specific department, then it's time for individual meetings to discuss your observations, impressions, and the objective performance factors that have emerged. Perhaps it is increased errors or an unwillingness to properly serve patients or assist a co-worker. Be willing to probe to find out what is on an employee's mind that is contributing to the performance decline, and what improvement issues are involved. You need to get a clear understanding of how the practice might help him or her improve.

Prepare a formal performance improvement plan (PIP) that addresses:

• the specific performance issue
• what corrective action the staff member is required to make
• how management will support the staff member during the interim
• the change you expect
• the time frame allowed for correction
• what actions will occur if the performance does not meet the expected results
• when you will meet again to review progress.